Shunt flushers and related methods

Abstract

Systems and methods for flushing shunt systems are disclosed herein. In some embodiments, a flusher includes a pinch tube that extends over a flush dome such that a user can simultaneously close the pinch tube and actuate the flush dome with a single motion. Flushing and refill valves of the system can be disposed in a cartridge that is laterally-offset from the flush dome, advantageously reducing the height profile of the flusher. Flushers with integrated shunt valves are also disclosed, as are shunt systems with restricted and unrestricted modes for selectively limiting the instances in which a user can open an auxiliary flow path through the system.

1 .- 41 . (canceled) 
     
     
         42 . A flusher comprising:
 a body that defines a collapsible flush dome;   a valve cartridge that houses a refill valve and a flush valve, the valve cartridge being laterally-offset from the flush dome;   a passive flow path that extends between an upstream port and a downstream port, at least a portion of the flow path being defined by a collapsible fluid pathway that extends across an exterior surface of the flush dome;   wherein the flush valve has a first position in which the flush dome is not in fluid communication with the upstream port or the passive flow path and a second position in which the flush dome is in fluid communication with the upstream port and the passive flow path;   wherein application of a force to the collapsible fluid pathway is effective to collapse the collapsible fluid pathway to block the passive flow path and to collapse the dome to move the flush valve to the second position and flush fluid through the upstream port.   
     
     
         43 . The flusher of  claim 42 , wherein the flush valve comprises a valve body that is compressed against a valve seat by an adjustment disc such that rotation of the adjustment disc is effective to change a threshold opening pressure of the valve. 
     
     
         44 . The flusher of  claim 43 , wherein the adjustment disc is threadably mounted in the valve cartridge. 
     
     
         45 . The flusher of  claim 44 , wherein the adjustment disc can be actuated from a position outside of a patient in which the flusher is implanted. 
     
     
         46 .- 56  (canceled) 
     
     
         57 . A shunt system, comprising:
 a catheter having a primary flow port and an auxiliary flow port;   a flusher configured to emit a flushing cough or pulse of fluid through the catheter;   wherein the shunt system is operable in a restricted mode in which a flush generated by the flusher is insufficient to open the auxiliary flow port and an unrestricted mode in which a flush generated by the flusher is sufficient to open the auxiliary flow port.   
     
     
         58 . The system of  claim 57 , wherein the flusher includes a control operable to switch the flusher between the restricted mode and the unrestricted mode. 
     
     
         59 . The system of  claim 58 , wherein the control can be actuated non-invasively. 
     
     
         60 . The system of  claim 58 , wherein the control can be actuated from a position outside of a patient in which the shunt system is implanted. 
     
     
         61 . The system of  claim 58 , wherein the control is magnetically-actuated or hydraulically-actuated. 
     
     
         62 . The system of  claim 58 , wherein the control comprises a valve. 
     
     
         63 . The system of  claim 58 , wherein the control adjusts a cracking pressure of a flush valve of the flusher. 
     
     
         64 . The system of  claim 58 , wherein the control adjusts an effective volume of a flush cavity of the flusher. 
     
     
         65 . The system of  claim 64 , wherein the control adjusts the effective volume by selectively inflating or deflating an inflatable member disposed within the flush cavity. 
     
     
         66 . The system of  claim 64 , wherein the control adjusts the effective volume by moving at least a portion of a sidewall of the flush cavity. 
     
     
         67 . The system of  claim 64 , wherein the control adjusts the effective volume by selectively advancing or retracting a movable member into or out of the flush cavity. 
     
     
         68 . The system of  claim 57 , wherein the catheter includes a plurality of auxiliary flow ports, each having a progressively higher burst requirement. 
     
     
         69 . The system of  claim 57 , wherein the catheter includes a plurality of auxiliary flow ports, each covered by membranes having progressively higher thicknesses. 
     
     
         70 . The system of  claim 58 , wherein the control comprises a compliant feature movable between a collapsed state and an expanded state. 
     
     
         71 . The system of  claim 70 , wherein the compliant feature includes a passive flow path therethrough. 
     
     
         72 . The system of  claim 70 , wherein the compliant feature is in fluid communication with a flush emitted by the flusher, and wherein the compliant feature moves to the expanded state to absorb at least a portion of the flush when in the restricted mode. 
     
     
         73 . The system of  claim 70 , wherein the control comprises at least one valve that isolates the compliant feature from the flush emitted by the flusher when in the unrestricted mode and that places the compliant feature in fluid communication with the flush when in the restricted mode. 
     
     
         74 .- 77 . (canceled)